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Independent risk factors for the development of skin erosion due to incontinence in nursing home residents

Nele Van Damme (UGent) , Karen Van den Bussche (UGent) , Dorien De Meyer (UGent) , Ann Van Hecke (UGent) , Sofie Verhaeghe (UGent) and Dimitri Beeckman (UGent)
Author
Organization
Abstract
Background: Incontinence is a widespread problem in elderly care. One of the main complications is inflammation of the skin in the genital and anal region, also known as incontinence-associated dermatitis (IAD). Incidence figures vary between 3.4% and 25.0%. In order to provide cost-effective IAD prevention, it’s important to target skin care interventions to elderly at risk of IAD. However, little evidence exists on IAD risk factors. This study aimed to identify resident-related characteristics associated with the development of skin erosion due to incontinence (IAD category 2) in nursing homes. Method: The study sample consisted of 381 residents, from 11 Belgian nursing homes, incontinent for urine and/or stool. Data on demographical, physical, functional and psychological characteristics were collected at baseline and during a follow-up period of 30 days. Binary logistic regression analyses were performed to identify characteristics associated with IAD category 2 development. Using a multivariate model, independent risk factors were identified. Results: The mean age of the participants was 85.3 years. 49.4% of the participants were incontinent for urine, 0.9% for stool, and 49.7% for both urine and stool. The incidence of IAD category 2 was 6.0%. Residents with IAD were less mobile, more dependent and more likely to present erythema before skin erosion occurred. In addition, these residents were at higher risk of developing pressure ulcers and scored lower on the Braden subscales ‘activity’, ‘moisture’, ‘mobility’ and ‘friction and shear’. The presence of friction and shear problems (OR 0.39; 95% CI 0.16-0.981), severe restricted mobility (OR 0.37; 95% CI 0.14-0.94), and erythema due to incontinence (OR 3.02; 95% CI 1.04-8.73) were independently associated with developing IAD category 2. Conclusion: Care providers are recommended to target preventive skin care interventions to elderly with severe restrictions in mobility, difficulties with repositioning themselves in bed/chair, and erythema due to incontinence.

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Chicago
Van Damme, Nele, Karen Van den Bussche, Dorien De Meyer, Ann Van Hecke, Sofie Verhaeghe, and Dimitri Beeckman. 2017. “Independent Risk Factors for the Development of Skin Erosion Due to Incontinence in Nursing Home Residents.” In Research Day Faculties of Medicine and Health Sciences, and Pharmaceutical Sciences, Abstracts.
APA
Van Damme, Nele, Van den Bussche, K., De Meyer, D., Van Hecke, A., Verhaeghe, S., & Beeckman, D. (2017). Independent risk factors for the development of skin erosion due to incontinence in nursing home residents. Research Day Faculties of Medicine and Health Sciences, and Pharmaceutical Sciences, Abstracts. Presented at the Research Day and Student Research Symposium of the Faculties of Medicine and Health Sciences, and Pharmaceutical Sciences.
Vancouver
1.
Van Damme N, Van den Bussche K, De Meyer D, Van Hecke A, Verhaeghe S, Beeckman D. Independent risk factors for the development of skin erosion due to incontinence in nursing home residents. Research Day Faculties of Medicine and Health Sciences, and Pharmaceutical Sciences, Abstracts. 2017.
MLA
Van Damme, Nele, Karen Van den Bussche, Dorien De Meyer, et al. “Independent Risk Factors for the Development of Skin Erosion Due to Incontinence in Nursing Home Residents.” Research Day Faculties of Medicine and Health Sciences, and Pharmaceutical Sciences, Abstracts. 2017. Print.
@inproceedings{8520291,
  abstract     = {Background: Incontinence is a widespread problem in elderly care. One of the main complications is inflammation of the skin in the genital and anal region, also known as incontinence-associated dermatitis (IAD). Incidence figures vary between 3.4\% and 25.0\%. In order to provide cost-effective IAD prevention, it{\textquoteright}s important to target skin care interventions to elderly at risk of IAD. However, little evidence exists on IAD risk factors. This study aimed to identify resident-related characteristics associated with the development of skin erosion due to incontinence (IAD category 2) in nursing homes.
Method: The study sample consisted of 381 residents, from 11 Belgian nursing homes, incontinent for urine and/or stool. Data on demographical, physical, functional and psychological characteristics were collected at baseline and during a follow-up period of 30 days. Binary logistic regression analyses were performed to identify characteristics associated with IAD category 2 development. Using a multivariate model, independent risk factors were identified.
Results: The mean age of the participants was 85.3 years. 49.4\% of the participants were incontinent for urine, 0.9\% for stool, and 49.7\% for both urine and stool. The incidence of IAD category 2 was 6.0\%. Residents with IAD were less mobile, more dependent and more likely to present erythema before skin erosion occurred. In addition, these residents were at higher risk of developing pressure ulcers and scored lower on the Braden subscales {\textquoteleft}activity{\textquoteright}, {\textquoteleft}moisture{\textquoteright}, {\textquoteleft}mobility{\textquoteright} and {\textquoteleft}friction and shear{\textquoteright}. The presence of friction and shear problems (OR 0.39; 95\% CI 0.16-0.981), severe restricted mobility (OR 0.37; 95\% CI 0.14-0.94), and erythema due to incontinence (OR 3.02; 95\% CI 1.04-8.73) were independently associated with developing IAD category 2.
Conclusion: Care providers are recommended to target preventive skin care interventions to elderly with severe restrictions in mobility, difficulties with repositioning themselves in bed/chair, and erythema due to incontinence.},
  author       = {Van Damme, Nele and Van den Bussche, Karen and De Meyer, Dorien and Van Hecke, Ann and Verhaeghe, Sofie and Beeckman, Dimitri},
  booktitle    = {Research Day Faculties of Medicine and Health Sciences, and Pharmaceutical Sciences, Abstracts},
  language     = {eng},
  location     = {Ghent, Belgium},
  title        = {Independent risk factors for the development of skin erosion due to incontinence in nursing home residents},
  year         = {2017},
}